The Advantages and Challenges of Outsourcing Operational Support in the Healthcare Industry

Healthcare is one of the biggest and fastest expanding industries in the world.  Knowing how businesses grow with outsourcing can be used to your optimal advantage in the midst of a gliding health economy. However, to deliver exceptional patient care requires a considerable amount of resources and manpower. In effect, health facilities spend more on serviceable expenses to cater to the demand for quality.

In countries like the United States, there is a sky-high rise in the cost for healthcare. A recent Black Book Survey states, for an average hospital to break even, it needs to cut its cost to 24% by 2022. Fortunately, one great way to save overhead is outsourcing. An ever present need in any healthcare industry is Revenue Cycle Management which luckily can be outsourced. This entails some but not limited to the following:

• Patient Scheduling and Registration
• Insurance Verification
• Medical Coding
• Claims Submission
• Denial Management

But the big decision is not which outsourcing companies are available in the market pool, rather, understanding how outsourcing can be favorable for your business. Laying out the gains and pains is one great way to help you decide.

The Advantages

Allows Patient-Centered Care

Health practitioners cannot effectively provide excellent care if they are mired by the administrative and financial side of running a practice. By outsourcing non-core functions and optimizing revenue cycle management, you can focus more on what you do best — diagnosing and treating a patient. It is important to balance non-care responsibilities to promote curative and therapeutic services. Less administrative tasks help health personnel realign their focus on managing workload resulting in improved care standards and increased patient satisfaction. 

Reduce Billing Errors and Ensures Billing Compliance

Medical billing companies’ sole purpose is to guarantee that billing claims are accurately submitted in a timely manner. By hiring billers who underwent thorough training and those fully equipped with knowledge on the billing process reduces the number of denied and rejected medical claims. Altogether, it maximizes feedback assistance on reimbursements and future assets. Since this is an ever-changing industry, by working with an outsourced claims team, you stay up-to date with the latest changes in regulation and requirements to maintain compliance and ensure the submission of clean claim. 

Cost Effective and Improved Cash Flow

Most asked question in any industry is, “What to do if labor cost is growing faster than your business?”. By outsourcing, you can curb thousands of dollars from operational expenses while securing the steady flow of profit. Outsourcing generates a pool of professionals on behalf of the company, thereby saving you cost in acquiring and training additional staff. Reducing the workload and administrative burden from your staff increases productivity, efficiency and morale, which is directly proportional to increased patient satisfaction. Happy patients generate profit and improve cash flow by becoming living testimonies of the great service they received. Stable operations ensure quality health service, giving you a cutthroat advantage over your competitors.

However, with every gain comes with an analogues pain. To combat these challenges, awareness on these things fortify your success in the healthcare industry. 

The Challenges

Patient Data Privacy and Security Breach

Information breach predominantly transpires in healthcare thus careful evaluation of which outsourcing company to partner with is very crucial.  Not having direct control and supervision of outsourced staff can pose vulnerability on patient data and information. Whether intentional or accidental, unauthorized disclosure of patient’s information is a breach to the data privacy act and doctor-patient confidentiality. The more people who have access to private and confidential information, the greater the risk for breach. Knowing the pillars of information security is essential for providers and outsourcing partners to protect patient data and comply with HIPAA (Health Insurance Portability and Accountability Act of 1996) regulations. Other things to consider are companies with ISO-certification, complies with the General Data Protection Regulation (GDPR) and the Data Privacy Act of 2012, and superior IT infrastructure coverage. That being so, before considering any partnership, secure your position on the whole operational process.

Practical Limitations

Lack of access to information and miscommunication between the outsourcing company and the medical office can be limiting. In-house staff have easier access to hospital records and patient information than those off-shore. Therefore, during the contracting phase, it is crucial that the outsourcing team receives the proper information they need to function accordingly. It is equally important to partner with a company that has the proper tools and technical knowledge about your business to avoid viable disconnect.

Since outsourcing isn’t a panacea, it is the provider’s due diligence in ensuring that right services are outsourced to the right partners. Companies centered in building great teams of health professionals help you combat these limitations. Knowing the latest trends on the coverage and values of outsourcing also works to your advantage.

Process and Contractual Misunderstanding

Partnership may go downward spiral if the provider and the outsourcing party interpret the contract differently. No contract will ever be perfect, technical and legal lingo can cause contractual misunderstanding. Ergo, necessary adjustments on the terms and conditions should be implied. Managing expectations is as important as finding the right partner. Both parties are accountable in securing a fortified and effective linkage. That is why, before deciding to collaborate, medical providers should be aware of the common outsourcing misconceptions all the while surveying industry experts aligned with operational excellence. On the other hand, outsourcing companies should research more about the industry of their partners and arm their workforce with the proper technical knowledge. 

The Decision Phase

Weighing the advantages and challenges of outsourcing is the first step to embrace your company’s growth. Knowing the boons and banes of your prospective partners help you to identify what works best for your business. 

Finding the right partner is one of the biggest decisions you’ll ever make. Careful consideration of all the pains and gains of outsourcing can be dreary but is worth all the effort. Researching and reading more about the leitmotif catapults you to success because it gives you the liberty to choose what’s best for your company. True enough that there are a lot of fish in the sea – until you find the best team – then there’s only one. 

Infinit-O is the trusted customer-centric and sustainable leader in Business Process Optimization to Small and Medium businesses in the Financial Services, Healthcare and Technology sectors by delivering continuous improvement through technology, data and people.

We will assist in optimizing clinical documentation, streamlining medical claims, upto securing patient co-pay collection while you put more focus on patient care and promote patient wellness. By building great teams, we can match you to the right pool of  highly skilled doctors, dedicated license nurses and qualified medical coders that can help you grow your business. 

Start small. Exceed expectations. Think infinitely. Think Infinit-O.